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Background: The management of chronic hepatitis delta requires reliable test systems for the detection and quantification of hepatitis delta virus (HDV) RNA. The aim of this study was to obtain comparable results between seven European laboratories using the new RoboGene HDV RNA Quantification Kit 3.0 (Roboscreen GmbH) in combination with different test systems consisting of different nucleic acid extraction and amplification/detection platforms.
Methods: Correction factors (CFs) were determined to harmonize HDV RNA concentrations using the 1st WHO International Standard for HDV RNA (WHO IS HDV RNA). Limits of detection (LODs) were determined using a dilution series of the WHO IS HDV RNA. Reference material was used for accuracy testing. In addition, 20 dilutions of plasma sample pools obtained from untreated chronic hepatitis D patients were analyzed.
Results: The CFs ranged from 14 to 10,000 depending on the test system used. The calculated CFs were used for subsequent quantification. LODs ranged from <2.2 to >575 IU/mL. When accuracy was determined, the two lowest HDV RNA concentrations were not detected by the test system with the lowest sensitivity. When dilutions of pooled samples were tested, 7 of 140 results were reported as negative from all centers.
Conclusions: Test-specific CFs must be determined to harmonize HDV RNA quantification. Appropriate platforms for HDV RNA extraction are essential to achieve an adequate detection limit. Both high sensitivity and accurate quantification are important for the accurate monitoring of the response to existing anti-HDV treatment and for clinical trials of novel anti-HDV drugs.
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http://dx.doi.org/10.1016/j.jcv.2025.105828 | DOI Listing |
Antiviral Res
September 2025
Department of Infection, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address:
Background: Hepatitis D virus (HDV) infection is the most severe form of human viral hepatitis. A poor virus-specific CD8T cell response may result in persistent HDV infection. We investigated anti-viral effect and mechanisms of ubiquitinated small hepatitis D antigen (Ub-S-HDAg) in HBV/HDV superinfected liver organoids.
View Article and Find Full Text PDFBrief Bioinform
August 2025
Department of Computer Science, Ben-Gurion University of the Negev, David Ben-Gurion Blvd. 1, Beer-Sheva 8410501, Israel.
Hepatitis delta virus (HDV) is geographically classified according to eight known genotypes. The combined hepatitis B-hepatitis D (HEPB-HEPD) disease is the severest form of chronic viral hepatitis in humans and is characterized by mortality rates of ~20%. Hepatitis delta virus has no FDA approved therapy and its only available vaccine is the one for HEPB.
View Article and Find Full Text PDFWorld J Clin Cases
September 2025
Department of Hepatology, Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China.
Background: Hepatitis D virus-hepatitis B virus (HDV-HBV) co-infection accelerates liver disease progression and increases the risk of hepatocellular carcinoma, but the immunopathogenic mechanism of its combination with autoimmune hepatitis (AIH) has not been clarified. This study reveals for the first time that HDV may induce AIH through abnormalities in immunoregulation in two specific cases. This is the first report of HDV-HBV co-infected patients who did not receive interferon therapy and achieved serological conversion and histological remission by combining antiviral (entecavir) with immunosuppression (prednisone + azathioprine) therapy, providing new evidence of the mechanism of this complex disease.
View Article and Find Full Text PDFViruses
August 2025
Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Hepatitis D virus (HDV) infection remains a major cause of severe liver disease among hepatitis B virus (HBV)-infected patients, contributing to accelerated progression to cirrhosis and hepatocellular carcinoma. Pegylated interferon-α remains the first-line therapy for chronic HDV infection in most cases. However, despite its approval for HBV and hepatitis C virus (HCV) infections, its use in HDV is largely driven by a lack of other options and is constrained by its limited efficacy, suboptimal durability of response, and a substantial side effect profile.
View Article and Find Full Text PDFEmerg Microbes Infect
December 2025
Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, USA.
Recent studies have shown that the presence of an RNA modification, N6-methyladenosine (mA), in viral RNAs during infection significantly impacts the outcome of viral replication and pathogenesis. In particular, various functions of mA have been elucidated in hepatitis B virus (HBV), hepatitis C virus (HCV), and hepatitis delta virus (HDV). During viral infection, mA methylation not only directly affects the replication of these viruses but also regulates diverse cellular RNAs to control pathogenesis.
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